Pessimists always get to say ‘I told you so’

Whether the government dictators decide to restart the economy tomorrow or six months from now, there will be a spike in coronavirus cases and deaths and the fearmongers will delight in saying, “I told you so.”

They are just delaying the inevitable, though possibly flattening the curve a bit by stretching out the frequency of contacts and thus cases of COVOD-19. Is it worth it? What is the return on disinvestment and joblessness?

Another sure thing that everyone knew is also turning out to be not so sure: We need more ventilators.

AP is reporting today:

Generally speaking, 40% to 50% of patients with severe respiratory distress die while on ventilators, experts say. But 80% or more of coronavirus patients placed on the machines in New York City have died, state and city officials say.

Higher-than-normal death rates also have been reported elsewhere in the U.S., said Dr. Albert Rizzo, the American Lung Association’s chief medical officer.

Similar reports have emerged from China and the United Kingdom. One U.K. report put the figure at 66%. A very small study in Wuhan, the Chinese city where the disease first emerged, said 86% died.

The reason is not clear. It may have to do with what kind of shape the patients were in before they were infected. Or it could be related to how sick they had become by the time they were put on the machines, some experts said.

But some health professionals have wondered whether ventilators might actually make matters worse in certain patients, perhaps by igniting or worsening a harmful immune system reaction.

But everyone has been clamoring for ventilators. Maybe other things the experts know for certain are not certain.

Of course, Dr. Anthony Fauci has provided his daily ratcheting down of the projection numbers, saying, the final toll currently “looks more like 60,000 than the 100,000 to 200,000” that U.S. officials previously estimated.

And Knut Wittkowski, former head of the Department of Biostatistics, Epidemiology, and Research Design at the Rockefeller University in New York City, says the coronavirus could be “exterminated” if most people were permitted to lead normal lives and only the vulnerable are sheltered:

[W]hat people are trying to do is flatten the curve. I don’t really know why. But, what happens is if you flatten the curve, you also prolong, to widen it, and it takes more time. And I don’t see a good reason for a respiratory disease to stay in the population longer than necessary.

With all respiratory diseases, the only thing that stops the disease is herd immunity. About 80% of the people need to have had contact with the virus, and the majority of them won’t even have recognized that they were infected, or they had very, very mild symptoms, especially if they are children. So, it’s very important to keep the schools open and kids mingling to spread the virus to get herd immunity as fast as possible, and then the elderly people, who should be separated, and the nursing homes should be closed during that time, can come back and meet their children and grandchildren after about 4 weeks when the virus has been exterminated.

Editorial: Keep a close eye on enforcement of virus regulations

Shortly after state health officials confirmed the first presumptive case of the coronavirus — dubbed COVID-19 — in Nevada this past week, Gov. Steve Sisolak issued an emergency regulation regarding insurance coverage for testing and treatment of the rapidly spreading virus.

State law gives the governor the power in emergency situations to make, amend and rescind regulations in response to the emergency. Customarily one thinks of such things as calling out the National Guard to prevent looting or other problems after a national disaster.

In this case the Commissioner of Insurance Barbara Richardson made a finding that an emergency affecting the health and safety of the public exists and that adoption of an emergency regulation was appropriate.

What Sisolak did was attempt to avert potential adverse financial impact for those who carry health insurance.

We highly recommend the governor keep a close eye on the effects of his order lest it have unintentional adverse affects on the availability of testing and potential vaccines or treatments for the disease. Dictating the price of things in the marketplace has been known to deter availability of goods and services when adequate compensation is not forthcoming.

There has been plenty of anecdotal evidence over the years that so-called anti-price-gouging laws merely limit the supply of necessary goods and services in a crisis.

For example, according to the American Institute for Economic Research, in 2005 a Kentucky man took time off from his job, bought 19 power generators, rented a truck and drove to hurricane-ravaged Mississippi intending to sell the generators at twice the price he paid to cover his costs and make a profit. Police confiscated his generators for price gouging, held him for four days and kept the generators in police custody. Those who urgently needed them and would have gladly paid the asking price suffered in the dark instead.

“This pre-emptive emergency regulation should give Nevadans confidence to continue taking preventative measures to stop the spread of COVID-19 as well as seeking necessary medical services and prescriptions without fear of higher than normal costs,” Sisolak was quoted as saying in a press release accompanying the emergency declaration. “Protecting Nevadans is my top priority, and adopting this emergency regulation is a critical piece of our broader plan to anticipate and prepare for the potential impacts of COVID-19.”

The press release said the order prohibits a health insurance company from imposing an out-of-pocket charge for an office, urgent care center or emergency room visit for the purpose of testing for the virus. “Additionally, the regulation prohibits insurers from charging Nevadans for the COVID-19 test itself or an immunization as one becomes available and further requires coverage for off-formulary prescription drugs if a formulary drug is not available for treatment,” the press release says.

Sounds confiscatory. If companies are prohibited from recouping their expenses for services provided, how readily available will those services be?

The regulation further requires health insurance companies to pro-actively provide information on available benefits, options for medical advice and treatment through telehealth systems and ways to prevent exposure to the virus.

With only a few cases in Nevada so far such measures may be premature. There have been no reports of insurance price gouging due to the virus that we are aware of, which is what the governor’s emergency order appears to be intended to stave off.

We suggested the commissioner of insurance and health officials keep a close watch on events as they develop to assure these shackles on the free market do not interrupt the availability of necessary services and thus create the opposite effect of what the governor intends.

A version of this editorial appeared this week in some of the Battle Born Media newspapers — The Ely Times, the Mesquite Local News, the Mineral County Independent-News, the Eureka Sentinel,  Sparks Tribune and the Lincoln County Record.

Gov. Steve Sisolak announces emergency regulations. (R-J pix)